Health Psychology Commons^™

A Cross-Cultural Examination Of The Relations Among Parkinson’S Disease Impairments, Caregiver Burden And Mental Health, And Family Dynamics In Mexico And The United States, Erin Smith

Theses and Dissertations

Parkinson’s Disease (PD) is a common progressive neurodegenerative disorder that leads to both physical and cognitive impairment over time. Eventually, these impairments may include the loss of autonomy, and the individual may require the assistance of an informal caregiver. Informal caregivers are critical in the care of individuals with PD and spend substantial time providing care, which may be associated with negative caregiver outcomes such as burden, mental health issues, as well as poor family dynamics. Although research in the United States and Europe has generally supported these relations, there is very limited research on PD caregiving in Latin America. …

From Sunrise To Sunset: A Lifespan Approach To Understanding The Mental Health Of A Subset Of American Farmers, Janna L. Imel

Theses and Dissertations

Prior research has indicated higher risk of suicide for farmers and identified depression and anxiety as mental health concerns, though the majority of research was conducted in the 1980s-1990s. In today’s economic, social, and political climate, farmers are exposed to situations and stressors reminiscent of the 1980s Farm Crisis. An added risk is the aging workforce of farmers, as age-related conditions can make farming even riskier. This study investigated the mental health of a subset of American farmers by exploring farm-related stressors, coping mechanisms, and mental health outcomes. Dispositional mindfulness was explored as a specific coping mechanism. Participants (N …

The Influence Of Electronic Cigarette Heating Coil Resistance On Nicotine Delivery, Heart Rate, Subjective Effects, And Puff Topography, Marzena M. Hiler

Theses and Dissertations

Electronic cigarette (ECIG) users can manipulate several device features including liquid nicotine concentration (mg/ml) and heating coil resistance (Ohms). One class of ECIG models, called “sub-Ohm” devices, use coils with a resistance of < 1 Ohms, lower than those observed in conventional ECIGs (e.g., ≥ 1.5 Ohms). Increasing voltage or decreasing coil resistance increases device power. Given that ECIG coil resistance and liquid nicotine concentration have not been manipulated systematically and simultaneously in clinical laboratory studies, the influence of these factors on ECIG acute effects remain unclear. The primary purpose of this study was to examine the influence of coil resistance and liquid nicotine concentration on nicotine delivery, heart rate (HR), subjective effects, puff topography, and liquid consumption.

Thirty-two experienced ECIG users completed four independent laboratory sessions that differed by coil resistance (0.5Ohm or 1.5Ohm ) and liquid nicotine concentration (3 or 8 mg/ml). In each session, participants used a 4.5 V “Kanger SUBOX” loaded with 3.5 ml ECIG liquid in a 10-puff directed and 60-minute ad libitum bout. Nicotine delivery was greatest when using 8 mg+0.5Ohm combination and lowest when using the 3 mg/ml+1.5Ohm …

Adverse Childhood Experiences, Neighborhood Disorganization, Co-Parenting: The Impact On College Student Mental Health, Mona L. Quarless

Theses and Dissertations

Though mental health issues are prevalent amongst college students, pre-college environment and experiences are largely overlooked as potential factors in scientific literature. The current study examined the association of neighborhood disorganization, Adverse Childhood Experiences (ACEs) and mental health outcomes in a sample of college students. Utilizing the ecological model of human development and risk-resilience framework, I examined co-parenting quality as a plausible protective factor against the negative effects of adverse childhood experiences and neighborhood disorder. Self-report measures of ACEs, co-parenting quality, neighborhood disorder, anxiety, and depression were completed by a sample of college students (N = 259; mean age = …

The Role Of Strength: Navigating Perinatal Loss Among Black Women, Ashley N. Hill

Theses and Dissertations

In the U.S., Black mothers experience fetal and infant mortality at alarming rates when compared to White and Latina mothers (Gregory, Drake, & Martin, 2018). The intent of this study was to examine perinatal loss among Black American women and to expand understanding of how the Strong Black Woman (SBW) ideology influences bereavement. Data were gathered from (N=109) Black American bereaved mothers. It was predicted that endorsement of differing aspects of the SBW would moderate the relationship between perinatal grief and psychosocial outcomes (i.e., depression and post-traumatic growth). Regression analyses, alongside a bootstrapping procedure via PROCESS (Hayes, 2017), …

An Evaluation Of Differences In Motivations To Receive Cervical Cancer Screening And Follow-Up Care Between Black And White Women, Ashlee Sawyer

Theses and Dissertations

Background: Cervical cancer among Black women is a major individual and public health concern. Despite advancements in medical technology and policy, disparities in cervical cancer diagnosis and mortality still exist between White and Black women, with Black women having higher rates of diagnosis (10.0 vs 7.1 per 100,000) and mortality (4.1 vs 2.0 per 100,000). Previous studies have focused heavily on barriers to obtaining cervical cancer screening among Black women and efforts to improve screening rates. Despite speculation by researchers that gaps in receipt of quality follow-up care may contribute to disparities, its role in disparate mortality rates between Black …

Examining Sleep And Family Functioning In Pediatric Craniopharyngioma Using Ecological Momentary Assessment, Nour Al Ghriwati

Theses and Dissertations

Craniopharyngiomas are among the most common brain tumors in children and are associated with greater rates of sleep problems compared to other pediatric cancers. However, research examining sleep among youth with craniopharyngioma has been limited by a reliance on retrospective reports or sleep studies. Families also play a crucial role in children’s adjustment following a pediatric cancer diagnosis, yet remarkably little is known about transactional associations between family functioning and sleep in pediatric cancer. This study examined cross-sectional and daily associations among family functioning, affect, and sleep difficulties for youth with pediatric craniopharyngioma using retrospective reports and ecological momentary assessment …

Construction And Validation Of A Non-Medical Use Of Prescription Opioids Outcome Expectancies Scale Among College Students In China, Cheuk Chi Tam

Theses and Dissertations

Background:Non-medical use of prescription opioids (NMUPO) has become a clear threat to public health. Young adults (aged 18 to 25) have a high risk of NMUPO. My prior work on Chinese undergraduates indicates a high prevalence of lifetime NMUPO (49.2%). Health behavior theories propose that outcome expectancies are robust psychosocial determinants of substance use. Literature has identified the influence of outcome expectancies on alcohol and drug use. However, the role of outcome expectancies in NMUPO in China is unknown, and a scarcity of a valid measures for NMUPO outcome expectancies may be a barrier. Our previous research also found …

Effects Of Electronic Cigarette Liquid Solvents Propylene Glycol And Vegetable Glycerin On User Nicotine Delivery, Heart Rate, Subjective Effects, And Puff Topography, Tory Spindle

Theses and Dissertations

Electronic cigarettes (ECIGs) are a class of tobacco products that use a heating element to aerosolize a liquid, typically containing nicotine, allowing for user inhalation. Despite their rapid growth in popularity, little is known about ECIGs including how certain device and liquid factors influence nicotine delivery, user physiological and subjective responses, and puffing behavior (puff topography). Limited pre-clinical research has demonstrated that the ratio of two solvents commonly found in ECIG liquids, propylene glycol (PG) and vegetable glycerin (VG), may have an influence on the nicotine content of ECIG aerosols. However, the extent to which PG:VG ratio in ECIG liquids …

From Blacker The Berry To Darker The Flesh: Gendered Racial Microaggressions, Ethnic Identity, And Black Women’S Sexual Behaviors, Chelsie E. Dunn

Theses and Dissertations

Race- and gender-related contextual factors influence Black women’s sexual behaviors, attitudes, and outcomes. Contextual factors of Black women’s sexual behaviors include stereotypes, microaggressions, ethnic identity, and self-concept. Little to no research has examined race- and gender-specific microaggressions (i.e., gendered racial microaggressions; GRM) impact on Black women's sexual health. Responsively, using an intersectional approach, this study hypothesized that ethnic identity’s influence on the relationship between GRM and sexual behavior (i.e., condom use, lifetime sexual partners) is conditional on self-conceptualization moderated effect on ethnic identity and sexual behavior. Participants included 124 unmarried Black women, recruited from mTurk, a southeastern university and community. …

Discrimination, Mental Health, And Preparedness For Aging In Trans(Gender)/Gender-Nonconforming Adults, Richard S. Henry

Theses and Dissertations

This cross-sectional study examined relationships among discrimination, mental health (i.e., depression and anxiety), preparation for aging (i.e., familiarity and planning), social support, death attitudes, and aging anxiety among TGNC adults (N = 154). Neither discrimination nor mental health predicted preparation for aging familiarity or planning. Discrimination did, however, predict both anxiety and depression, although only the non-affirmation subscale was a unique predictor of both. As discrimination and mental health were not a significant predictor of preparedness for aging in the previous regressions, the hypothesized mediation model and subsequent moderated mediation models were not conducted. Additional exploratory multiple regressions were …

Examining Two Structural Equation Models To Determine The Effect Of Parental Practices And Familial Cultural Values On Mexican Adolescents’ Sexual Health, Efren A. Velazquez

Theses and Dissertations

Sexual behavior is a normative part of adolescence and it is important to understand how familial factors influence Latina/o adolescents’ sexual health. The current study examined two structural equation models (SEM) and the associations between familial cultural values (i.e., familismo and filial piety), maternal and paternal monitoring (i.e., disclosure and solicitation) and Latina/o adolescent’s sexual behavior (i.e., intentions to have sex, sexual behavior, sexual responsibility). A hypothesized SEM examined whether paternal/maternal monitoring mediated the relation between familial cultural values and adolescents’ sexual health, while an alternative SEM examined whether familial cultural values mediated the association between paternal/maternal monitoring and adolescents’ …

Investigating Racial Bias In Perceptions Of Free Will, Courtney J. Alderson

Theses and Dissertations

The overarching goal of this study was to examine whether perceptions of others’ free will would differ depending on perceiver race as well as target race. The current study proposed that such a racial bias may be one mechanism by which racial disparities in medical treatment recommendations arise. By bridging findings from four different lines of research (i.e., the literatures on racial health and medical treatment disparities, racial bias, free will beliefs, and social identity), it was hypothesized that: (1) participants would perceive greater amounts of free will for a hypothetical racial ingroup patient than an outgroup patient; (2) such …

A Stakeholder Examination Of Gestational Weight Gain Guidelines, Melissa Kwitowski

Theses and Dissertations

Obesity is a significant health concern for women of childbearing age. More than 40% of women have a Body Mass Index (BMI) in the overweight or obese ranges at the time they conceive, posing significant health risks for both mother and child. Excessive weight gain during pregnancy is common and associated with numerous deleterious complications. The Institute of Medicine published gestational weight gain (GWG) guidelines based on prepregnancy BMI. However, more than 50% of women gain in excess of these recommendations. Further, many women report receiving minimal guidance from their healthcare providers regarding weight gain, nutrition, and physical activity during …

Queer Health Equity And Cervical Cancer: Identifying Social Determinants Of Papanicolaou Test Uptake In A Sample Of Sexual Minority Women And Gender Nonbinary Individuals, Ariella R. Tabaac

Theses and Dissertations

Sexual minority women (SMW) demonstrate lower rates of cervical cancer screening than heterosexual women. This is concerning as lesbian and bisexual women tend to engage in higher rates of substance-related cancer risk behaviors, unprotected sex, and tend to have higher body mass indices, all of which are risk factors for cancer development. Another major risk factor, screening avoidance, places SMW at increased risk for the development of high grade cervical lesions in the absence of early detection practices, which is likely to impact overall cervical cancer morbidity in this population. The aim of the present study was to utilize the …

A Laboratory Study Of Stress Reactions To Witnessing A Police Killing Of An Unarmed Black Man: Discrimination, Distress Tolerance, Ethnic Identity, And Risk-Taking, Michael A. Trujillo

Theses and Dissertations

Black individuals have been disproportionately targeted by law enforcement, most notably in shooting deaths at the hands of police, and has contributed to a general distrust of law enforcement. A rise in citizen journalism has helped document excessive use of force by police on video; however, little is known how individuals respond to viewing this type of media. A history of race-based stress is likely to contribute to an expectation of racism and may impact how individuals respond to videos of the treatment of unarmed Black men at the hands of police, with some evidence suggesting ethnic identity may moderate …

Abuse Liability Of An Electronic Cigarette In Traditional Cigarette Smokers, Sarah F. Maloney

Theses and Dissertations

Electronic cigarettes have grown in popularity across the U.S. and concerns have been raised about their abuse liability. The purpose of the current study was to evaluate and compare the abuse liability of an electronic cigarette with and without nicotine to a nicotine inhaler (the Nicotrol inhaler) and participants’ own brand of cigarettes. A total of 24 smokers attended four sessions in which the abuse liability of each product was examined using the Multiple-Choice Procedure (MCP), nicotine delivery, nicotine abstinence symptom suppression, and subjective reinforcing effects. Results revealed that the nicotine containing and non-nicotine containing electronic cigarette had a higher …

Peer Rejection And Emotion Development: The Role Of Peer Rejection And Coming Out On Emotional Health Among Gay And Bisexual Men, Joseph A. Carter

Theses and Dissertations

Gay and bisexual men experience a higher prevalence of negative mental health outcomes than their heterosexual counterparts. This study examines sexual identity milestone achievement—the age of first coming out to friends—for mediation on the association between childhood experiences of peer rejection and levels of emotion dysregulation in adulthood.

A Hierarchical Linear Modeling Approach To Predicting Trajectories Of Posttraumatic Growth In Veterans Following Acquired Physical Disability, Lisa Goldberg Looney

Theses and Dissertations

The purpose of this study was to examine potential predictors of PTG across time in Veterans with acquired physical disabilities. Specifically, this study aimed to understand how various demographic and injury characteristics, coping styles, appraisals of injury, and social support might predict trajectories of PTG from discharge from inpatient rehabilitation through 12 months after baseline. Initial curvature analyses suggested that a cubic polynomial trend best fit the movement of PTG over time, generally conforming to an initial increase, decrease, and then plateau or slight increase. Four HLMs were run to examine whether demographic and injury characteristics, coping styles, appraisals of …

Effects Of Cumulative Risk On Asthma Outcomes In Urban Children And Adolescents, Samantha A. Miadich

Theses and Dissertations

Pediatric asthma disproportionately affects racial/ethnic minority children and children living in low-income, urban areas. Many families living in low-income, urban areas experience a number of stressors that can place children/adolescents at risk for worse asthma outcomes. This study examined the impact of a cumulative risk model of stressors (e.g., ED visits, quick-relief medication use, lung function, asthma control, QOL) in urban children (7-12 years) with persistent asthma. This study further aimed to examine both the original cumulative risk model and an adolescent-specific cumulative risk model as predictors of asthma outcomes in a sample of 60 adolescents (13-17 years). Asthma-related caregiver …

Implementing Integrated Care In Family Medicine: Description And Outcomes In An Underserved Population, Zach Radcliff

Theses and Dissertations

Introduction: Family physicians provide access to medical and behavioral healthcare for many underserved populations. Integrating behavioral health clinicians into primary care practices has been proposed as one of the most effective ways to increase access to necessary behavioral health services for many Americans. Integrated behavioral healthcare (IBHC) has begun to be implemented in family medicine practices but there is limited research examining the impact for patients and clinic staff. This study begins to fill this gap in the literature by examining the effects of implementing integrated behavioral healthcare in an urban family medicine clinic in a medically underserved area.

Objective: …

The Role Of Afrocentric Features In Mental Healthcare Utilization And Counselor Preferences In Black College Students, Randl B. Dent

Theses and Dissertations

Though mental health issues are prevalent in Black young adults, they underutilize mental healthcare services. This research examined the role of feature-based discrimination in mental healthcare (under)utilization. Study 1, a secondary analysis of the National Longitudinal Study of Adolescent to Adult Health, provided no evidence supporting a link between skin tone and mental healthcare utilization, when controlling for depression diagnosis. However, when controlling for depression symptoms, there was a trend such that Black young adults with darker, as opposed to lighter, skin tone utilized healthcare less. Study 2, an experimental study with 33 Black college students, showed 73% of the …

Non-Medical Use Of Prescription Drugs, Stress, Cultural Orientation, Utilization Of Healthcare, And Protective Factors Among College Students In China, Cheuk Chi Tam

Theses and Dissertations

Background: Non-medical use of prescription drugs (NMUPD) refers to the use of prescription drugs which are traditionally utilized to manage pain or treat psychiatric problems but without a doctor’s prescription. In 2010, an investigation by the Substance Use and Mental Health Services Administration (SAMHSA) revealed that 5.3% of young adults (18 to 25-year-olds) in the United States reported past-month NMUPD. NMUPD has become a growing concern owing to associations with consequences such as college dropout, poor academic achievement, and health jeopardizing behaviors. College students' NMUPD has been well documented in the United States. Limited studies, however, have been conducted among …

Examining Health Behaviors In College Students With And Without Chronic Conditions, Duc-Thi J. Barsell

Theses and Dissertations

Many college students are in a developmental period in which they are transitioning from pediatric to adult health care. This time period can be challenging for all college students and especially for students with a chronic condition. The current study investigated the association between various health-related factors (health locus of control [HLOC], health literacy, health self-efficacy, and health-related quality of life [HRQOL]) and health behaviors in college students, as well as the moderating effect of having a chronic condition on those associations. These health behaviors were further operationalized as healthy lifestyle behaviors (preventative and wellness behaviors, dietary behaviors, physical activity) …

An Integrated Behavioral Model Of Healthcare Utilization Among Transgender And Gender-Nonconforming Adults, Megan Elizabeth Sutter

Theses and Dissertations

Transgender and gender-nonconforming (TGNC) individuals in the United States experience significant marginalization due to stigma enacted at the structural, interpersonal, and individual levels. As a result, this population has reported increased behavioral and physical health needs, as well as unique barriers to healthcare. Moreover, TGNC individuals have reported greater experiences of childhood abuse compared to cisgender individuals. The cumulative experiences of stigma-related stressors and adverse childhood experiences put this population at risk for the development of mental and physical health problems, increasing need for health services. However, TGNC individuals have reported being denied medical care and postponing seeking care due …

Sustainable Adapted Treatments For Eating Disorders: The Role Of Cultural Adaptation In Prevention, Sarah J. Javier

Theses and Dissertations

Despite demonstrating eating disorder rates equivalent to White women, African American and Asian American women are less likely to seek treatment and are more likely to terminate treatment prematurely. One of the most successful programs for eating disorder prevention has only focused on surface-level cultural adaptations. Prevention literature maintains that deep-structure cultural adaptation (e.g., integrating cultural values and beliefs) can enhance outcomes for ethnic minorities. This dissertation examined the feasibility of Sustainable Adapted Treatments for Eating Disorders (SATED), a pilot intervention that included a culturally- targeted pre-treatment to an eating disorder dissonance-based intervention. A sample of 72 women (ages 18-30) …

Protective Factors In The Association Between Child Sexual Abuse And Telomere Length In Adults, David Sosnowski

Theses and Dissertations

The purpose of the present study was to examine if childhood sexual abuse (CSA) was associated with decreases in mean telomere length (TL), and if social support and/or optimism moderated this association. The study included 99 Caucasian female monozygotic twins, ranging in age from 19-48 (M_age = 30.5, SD = 7.8) at Time 1. Linear mixed effects models were employed to test study hypotheses. Analyses with all participants did not detect an effect of CSA exposure or severity on mean TL, nor were there effects with optimism. However, in analyses that only included women exposed to abuse, increases …

Exploring The Role Of Motivational Interviewing In Adolescent Patient-Provider Communication About Type 1 Diabetes, Laura J. Caccavale

Theses and Dissertations

Type 1 diabetes (T1D) is one of the most common pediatric chronic illnesses. Glycemic control among patients with T1D often deteriorates during adolescence; yet little is known about the most effective way for providers to communicate with adolescents to prevent this decline. Given the importance of effective communication, examination of effective patient-provider communication strategies is needed. The current investigation used Motivational Interviewing (MI) as a framework to help characterize naturally-occurring adolescent patient-provider communication in medical encounters and examined the relations between provider communication and T1D self-management and control.

Participants were five pediatric endocrine providers and 55 adolescents with T1D (49% …

Mechanisms Of Motivational Interviewing In A Parent-Focused Pediatric Obesity Intervention, Nadia Islam

Theses and Dissertations

Pediatric obesity is a major public health epidemic with serious physical and psychological consequences. Difficulty engaging families in treatment is a significant obstacle in addressing pediatric obesity, especially among underserved populations. Motivational interviewing (MI) is a collaborative, person-centered communication style that has been shown to reduce attrition, increase attendance, and improve patient treatment adherence; however, little is known about the process of MI and how it improves treatment engagement. This study examined clinician and parent language in a pre-treatment MI session that increased initial engagement in a parent- focused pediatric obesity intervention (N= 81). Results showed that increased parent change …

Predictors Of Substance Use, Relationship Arrangements And Intimacy Expectancies Among Gay Couples And Associations To Erikson Intimacy Development, Jonathan Lopez Matos

Theses and Dissertations

This study explored relationship arrangements, intimacy expectancies of substance use and the potential role of Eriksonian intimacy development on drug use among gay and bisexual men. Data were collected from 339 partnered gay/bisexual men across the United States. Measures addressed arrangement type, intimacy expectancies, Eriksonian intimacy and drug use.